Insecure access to food and water are experienced by millions of people around the world. Not only does insecure access to food and water represent a violation of basic human rights, it is a major threat to the physical and mental health of individuals and communities. There is, therefore, great need for tools to identify those who are food and water insecure and the severity of their insecurity. We argue here that measures of food and water insecurity must not only reflect biological requirements but also the biocultural nature of food and water needs. In this paper, we present case studies from Tanzania and Bolivia that detail the steps used to adapt or create experience-based measures and validate these measures using a suite of established approaches. We also show that, by broadening our understading of insecurity to include respondents' experiences, the full range of health impacts—including psychosocial stress and mental health—become apparent. We conclude by noting limitations of the biocultural approach and offer suggestions for future research.

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